Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.
J Med Internet Res. 2022 Feb 9;24(2):e32392. doi: 10.2196/32392.
There are a host of emergent technologies with the potential to improve hospital care in low- and middle-income countries such as Vietnam. Wearable monitors and artificial intelligence-based decision support systems could be integrated with hospital-based digital health systems such as electronic health records (EHRs) to provide higher level care at a relatively low cost. However, the appropriate and sustainable application of these innovations in low- and middle-income countries requires an understanding of the local government's requirements and regulations such as technology specifications, cybersecurity, data-sharing protocols, and interoperability.
This scoping review aims to explore the current state of digital health research and the policies that govern the adoption of digital health systems in Vietnamese hospitals.
We conducted a scoping review using a modification of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. PubMed and Web of Science were searched for academic publications, and Thư Viện Pháp Luật, a proprietary database of Vietnamese government documents, and the Vietnam Electronic Health Administration website were searched for government documents. Google Scholar and Google Search were used for snowballing searches. The sources were assessed against predefined eligibility criteria through title, abstract, and full-text screening. Relevant information from the included sources was charted and summarized. The review process was primarily undertaken by one researcher and reviewed by another researcher during each step.
In total, 11 academic publications and 20 government documents were included in this review. Among the academic studies, 5 reported engineering solutions for information systems in hospitals, 2 assessed readiness for EHR implementation, 1 tested physicians' performance before and after using clinical decision support software, 1 reported a national laboratory information management system, and 2 reviewed the health system's capability to implement eHealth and artificial intelligence. Of the 20 government documents, 19 were promulgated from 2013 to 2020. These regulations and guidance cover a wide range of digital health domains, including hospital information management systems, general and interoperability standards, cybersecurity in health organizations, conditions for the provision of health information technology (HIT), electronic health insurance claims, laboratory information systems, HIT maturity, digital health strategies, electronic medical records, EHRs, and eHealth architectural frameworks.
Research about hospital-based digital health systems in Vietnam is very limited, particularly implementation studies. Government regulations and guidance for HIT in health care organizations have been released with increasing frequency since 2013, targeting a variety of information systems such as electronic medical records, EHRs, and laboratory information systems. In general, these policies were focused on the basic specifications and standards that digital health systems need to meet. More research is needed in the future to guide the implementation of digital health care systems in the Vietnam hospital setting.
有许多新兴技术有可能改善越南等低收入和中等收入国家的医院护理。可穿戴式监测器和基于人工智能的决策支持系统可以与医院的数字健康系统（如电子健康记录[EHR]）集成，以相对较低的成本提供更高水平的护理。然而，这些创新在低收入和中等收入国家的适当和可持续应用需要了解当地政府的要求和规定，如技术规格、网络安全、数据共享协议和互操作性。
本范围综述旨在探讨越南医院数字健康研究现状以及管理数字健康系统采用的政策。
我们使用 PRISMA-ScR（系统评价和荟萃分析扩展的首选报告项目用于范围综述）指南的修改版进行了范围综述。在 PubMed 和 Web of Science 上搜索学术出版物，在 Thư Viện Pháp Luật（越南政府文件的专有数据库）和越南电子卫生管理局网站上搜索政府文件。使用 Google Scholar 和 Google Search 进行滚雪球式搜索。通过标题、摘要和全文筛选对来源进行评估，以符合预先确定的入选标准。从纳入的来源中提取相关信息并进行图表和总结。审查过程主要由一名研究人员进行，并在每个步骤中由另一名研究人员进行审查。
共有 11 篇学术出版物和 20 篇政府文件纳入本综述。在学术研究中，5 篇报告了医院信息系统的工程解决方案，2 篇评估了电子健康记录实施的准备情况，1 篇测试了医生在使用临床决策支持软件前后的表现，1 篇报告了国家实验室信息管理系统，2 篇综述了卫生系统实施电子卫生和人工智能的能力。在 20 份政府文件中，有 19 份是在 2013 年至 2020 年颁布的。这些法规和指南涵盖了广泛的数字健康领域，包括医院信息管理系统、一般和互操作性标准、卫生组织网络安全、提供健康信息技术（HIT）的条件、电子健康保险索赔、实验室信息系统、HIT 成熟度、数字健康战略、电子病历、电子健康记录和电子卫生架构。
越南关于医院数字健康系统的研究非常有限，特别是实施研究。自 2013 年以来，针对电子病历、电子健康记录和实验室信息系统等各种信息系统，政府发布了越来越多的医疗保健组织 HIT 法规和指南。总的来说，这些政策侧重于数字健康系统需要满足的基本规范和标准。未来需要更多的研究来指导越南医院环境中数字医疗保健系统的实施。
